BOWEL PREPARATION FOR COLONOSCOPY

The purpose of the following instructions is to provide good bowel preparation prior to colonoscopy to enhance the quality and safety of the examination. Failure to comply with these instructions may result in having to repeat the bowel Preparation and reattempt colonoscopy at a later date. If questions arise regarding the bowel preparation please do not hesitate to contact the office and resolve these.

1. Please avoid corn and tomato skins for 24 hours prior to the examination these frequently plug the scope channel.

2. Avoid aspirin for one week prior to the examination aspirin may contribute to bleeding problems following biopsy or polyp removal.

3. Avoid other arthritis medications for 24 hours prior to the examination these agents may also increase the likelihood of bleeding, but their effect is reversible with avoidance of the medication for several hours.

4. If you are taking an iron preparation, please discontinue it two or three days prior to the scheduled examination.

5. Please continue all medications that you are taking with the exception of aspirin and arthritis medications as noted above. If you are taking Insulin or diabetes pills, please get special instructions from Dr. Cook or his nurse.

6. Since sedation is used during the examination it will be necessaries for you to have a friend or family member drive you home after the exam.

BOWEL PREPARATION

On ___________________only clear liquids may be taken for breakfast, lunch and dinner (clear liquids include: water, coffee, tea, soda pop, clear fruit juice apple, grape, cranberry; bouillon, plain jell-o (NO RED JELLO), Gatorade. NO SOLID FOODS, MILK OR MILK PRODUCTS ALLOWED.

Between 3-5 p.m. take the Reglan tablet. Twenty minutes later you may start drinking the Colyte solution. You should try and drink the entire gallon over three hours. This can be accomplished by drinking one cup every ten to fifteen minutes.

On __________________________you may have clear liquids until the time of the exam. Please report to________________
at _______________________

IF YOU TAKE BLOOD PRESSURE, HEART OR LUNG MEDICATION IN THE MORNING, PLEASE BE SURE TO TAKE YOUR MEDICATION BEFORE COMING TO THE HOSPITAL.

NOTE: IF YOU CANCEL YOUR PROCEDURE WITHIN 24 HOURS OF SCHEDULED TIME, YOU WILL BE CHARGED $100 00